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The nurse is caring for a postpartum client with excessive bleeding. What is the priority nursing intervention?
- A. Administer IV fluids.
- B. Massage the uterine fundus.
- C. Notify the healthcare provider.
- D. Check the client's vital signs.
Correct Answer: B
Rationale: The correct answer is B: Massage the uterine fundus. This is the priority intervention because excessive bleeding postpartum may indicate uterine atony, which can lead to hemorrhage. Massaging the uterine fundus helps to stimulate uterine contractions and control bleeding. Administering IV fluids (A) can be important, but controlling bleeding takes precedence. Notifying the healthcare provider (C) can be done after implementing immediate interventions. Checking vital signs (D) is important, but addressing the underlying cause of bleeding is the priority.
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Placental circulation is dependent on maternal circu- tions for preventing sudden infant death syndrome? lation. In which maternal circumstances is placental Select all that apply. circulation impeded? Select all that apply.
- A. Position newborns in the prone position to
- B. Hypotension
- C. Pre-eclampsia
- D. Avoid soft bedding or pillows in the newborn's
Correct Answer: B
Rationale: The correct answer is B: Hypotension. Hypotension in the mother can result in decreased blood flow to the placenta, affecting placental circulation and oxygen delivery to the fetus, increasing the risk of sudden infant death syndrome.
A: Positioning newborns in the prone position does not directly impede placental circulation.
C: Pre-eclampsia can affect placental circulation due to high blood pressure, but it is not the only maternal condition that can impede placental circulation.
D: Avoiding soft bedding or pillows in the newborn's crib is related to safe sleep practices but does not directly impede placental circulation.
The nurse assures the breastfeeding mother that she will know that her infant is getting an adequate supply of breast milk if the infant gains weight and:
- A. Rarely sucks on a pacifier.
- B. Ha several hard stools daily
- C. Voids 6 or more times a day
- D. Awakens to feed every 4 hours
Correct Answer: C
Rationale: The correct answer is C: Voids 6 or more times a day. Adequate breast milk intake is indicated by frequent urination (6 or more times/day) in infants. This shows the infant is hydrated and receiving enough milk. The other choices are incorrect because A) pacifier use doesn't indicate milk supply, B) hard stools can be a sign of dehydration or other issues, and D) feeding every 4 hours is a general guideline but not a definitive indicator of milk supply.
Why would FAM not be appropriate for the nurse to recommend to a perimenopausal person?
- A. At that age, people do not have intercourse on a regular basis.
- B. They are married and do not need contraception.
- C. They have irregular menstrual periods.
- D. Pregnancy is not a concern when a person is perimenopausal.
Correct Answer: C
Rationale: The correct answer is C because perimenopausal individuals often have irregular menstrual periods, making FAM less reliable for tracking ovulation. Irregular periods can make it challenging to accurately predict fertile days. Choice A is incorrect because FAM is not solely for contraception but also for fertility awareness. Choice B is incorrect as FAM can still be used for tracking fertility even if contraception is not needed. Choice D is incorrect because while pregnancy risk decreases during perimenopause, it is not zero, and FAM can still be helpful for those who wish to avoid pregnancy.
The nurse is preparing a postpartum client for discharge. Which instruction is most important?
- A. Avoid breastfeeding if you feel tired.
- B. Report foul-smelling lochia to your doctor.
- C. Resume all physical activity immediately.
- D. Stop taking your prenatal vitamins after discharge.
Correct Answer: B
Rationale: The correct answer is B: Report foul-smelling lochia to your doctor. This instruction is crucial because foul-smelling lochia can indicate an infection, which requires immediate medical attention to prevent complications. Reporting this to the doctor promptly ensures timely treatment.
A: Avoid breastfeeding if you feel tired - Incorrect. Breastfeeding is important for the baby's nutrition and bonding, regardless of the mother's fatigue.
C: Resume all physical activity immediately - Incorrect. Gradual resumption of physical activity is recommended to allow the body to heal properly.
D: Stop taking your prenatal vitamins after discharge - Incorrect. Prenatal vitamins are beneficial for postpartum recovery and breastfeeding, so stopping them abruptly is not advisable.
The nurse is counseling a client on the proper con- admitted to the labor and delivery unit complaining sumption of fish and fish products while pregnant. of mild contractions that are 10 minutes apart. How much fish should the nurse instruct the client After performing Leopold's maneuvers, the nurse to eat? determines that a hard round object is in the uterine
- A. 8 to 12 ounces of a variety of fish every week fundus. What should the nurse do if green fluid is
- B. 8 to 12 ounces of a variety of fish every month noted after rupture of the fetal membranes?
- C. 12 to 16 ounces of a variety of fish every week A.Observe the fetal monitor for variable decelerations
- D. 12 to 16 ounces of a variety of fish every month
Correct Answer: C
Rationale: The correct answer is C: 12 to 16 ounces of a variety of fish every week. During pregnancy, fish is a good source of protein and omega-3 fatty acids which are beneficial for fetal development. Consuming 12 to 16 ounces per week is recommended by health authorities for pregnant women to get essential nutrients without excessive mercury intake. Choice A (8 to 12 ounces of fish every week) is not enough for optimal nutrition during pregnancy. Choice B (8 to 12 ounces of fish every month) is too infrequent for consistent nutrient intake. Choice D (12 to 16 ounces of fish every month) is also inadequate as the frequency is not sufficient for optimal fetal development. Therefore, choice C is the best option for ensuring adequate nutrient intake while minimizing risks associated with mercury consumption.